dence, for instance, of the curative effects in their respective degrees, of cod-liver oil, of climate, of exchanging an in-door for an out-door life, even of the hypophosphites of lime and soda. Ignorant as we are both of the manner and the measure of benefit by these agencies, it is but just that each sufferer should have the opportunity of testing in his own person whether any of them reaches so far as to him. No promise can be held out beforehand of any particular result and, in the case of climate change, the selection of those that shall go and those that shall stay, fallible and often disastrous as it is, is governed for the most part by obvious considerations of common sense. And if this be true so far, there is surely something to be added upon the side of ethics. Whence do our "decrees of exile" derive their sanction? Does the language of the physician altogether coincide with the character of his knowledge? Is the adoption of a phraseology which recalls the terms and suggests the accuracy of science suitable to the circumstances of the case? Every reader will answer such questions for himself. We set out with the intention of reviewing the subject of treatment as addressed to the formed disease-phthisis. We have left out of sight all considerations of means of prevention and of the promise which a deeper insight into the pathology of the affection holds out for the future. It is the misfortune of medicine that it is both a science and a calling. At every stage of its progress, however ambiguous and immature the existing knowledge, it must always have a practical side, it must act as well as observe, and be ready to guide where it ought to explore. It hardly needs pointing out, as regards the disease whose treatment we have been considering, that this ever ready translation of principles into practice is a dangerous and fallible process. The facts may be so combined or selected as to favour help or that hypothesis. The hypothesis may be so presented as to favour this or that drug. Regarding medical science as the vulgar regard it, as employed in constructing a code of regulations for the sick needing constant readjustment, it may well appear that our practical gains are small and precarious, representing no fixed principle and dependent only on the temper of the hour. Treatment is at best empirical, and where empiricism fails there is legitimate room and scope for a host of theories and their corresponding remedies. No inference is secure and no practice destined to be permanent. So considered the present aspect of medicine is not bright nor its immediate future assuring. But there is another side where light is already shining and towards which PAGE REV. VI.—1. The Natural History and Relations of Pneumonia; a Clinical Study. By OCTAVIUS STURGES, M.D., F.R.C.P. London, 1876, pp. 336. 2. Croupous Pneumonia. Medicine at Tübingen. 62 73 ib. REV. VII.—1. Thirtieth Report of the Commissioners in Lunacy to the Lord 2. Eighteenth Annual Report of the General Board of Commissioners REV. VIII.—1. Studien in der Anatomie des Nervensystem, und des Binde- Studies in the Anatomy of the Nervous Centres and their Connective REV. IX.—A Treatise on Fractures and Dislocations. By F. H. HAMILTON. REV. X.-1. Leçons Cliniques sur les Maladies Mentales, professés à la Sal- 2. Récherches Cliniques et Thérapeutiques sur l'Epilepsie et l'Hysterie: . 102 ib. Bibliographical Record. ART. I.-1. The Normal Standard of Woman for Propagation. By NATHAN 2. The Law of Longevity. By same. 1874 126 ib. 3. Hereditary Disease. By same. 1873 ib. 4. Lessons on Population. By same. 1871 ib. 5. The Intermarriage of Relations. By same. 1869 ART. II.-Introduction to the Study of Chemical Philosophy. By W. A. 129 ART. III.-Chemia Coartata, or the Key to Modern Chemistry. By A. H. ART. V.—A Handbook of Therapeutics. By SYDNEY Ringer, M.D. Fifth edition, 1876 ART. VI.-Medical and Surgical Memoirs, containing Investigations on the Various Diseases. By JOSEPH JONES, M.D., &c. Vol. i. New Orleans, 1876 ART. VII.-A Treatise on Gout and Rheumatic Gout. By ALFRED B. GARROD, M.D., F.R.S. Third edition, thoroughly revised and enlarged. ART. VIII.—A Report on a Plan for Transporting Wounded Soldiers by ART. X.-How to use the Ophthalmoscope; being elementary instructions in BROWNE, Surgeon to the Liverpool Eye and Ear Infirmary, &c. . ART. XI.-On Medical and Surgical Electricity. By Drs. BEARD and ROCK- ART. XIII.—Reproductive Disorders; Spermatorrhagia; Exhausted Brain, PAGE 133 135 136 . 138 142 143 144 145 ART. XIV.-A Manual of Operative Surgery on the dead body. By T. 146 ART. XV.-Cases in Surgery; illustrative of a new method of applying the wire ligature in compound fracture of the lower jaw. By H. O. THOMAS. Second edition. Liverpool ART. XVI.-Outline drawiugs of the figure for recording the situation and 147 ib. ib. ART. XVIII.-Hay-Fever or Summer Catarrh; its Nature and Treatment, based on Original Researches and Observations, and containing Statistics and Details of several hundred cases. By GEORGE M. BEARD, A.M., M.D. Pp. 266. London and New York, 1876 ART. XIX.—On Tracheotomy, especially in relation to diseases of the Larynx and Trachea. By W. PUGIN THORNTON, Surgeon to the Hospital for Diseases of the Throat. Pp. 70. London, 1876 ART. XX.-The Treatment of Syphilis. By J. L. MILTON, Senior Surgeon to St. John's Hospital for Diseases of the Skin ART. XXI.-A Contribution to the Treatment of Uterine Versions and Flexions. By EPHRAIM CUTTER, A. M., M.D. Original Communications. PAGE I.-Life-Vitalists and Physicists, Teleology. By ROBERT GARNER, F.R.C.S. Eng., F.L.8., &c. II. The Connective Tissue Question, illustrated by a consideration of the present state of opinion on some disputed points. By GEORGE THIN, M.D. 157 180 Chronicle of Medical Science. : Report on Physiology and Histology. By HENRY POWER, F.R.C.S., M.B. Report on Physiological and Pathological Chemistry. By A. H. CHURCH, RICHARDSON, M.D., F.R.S. Reclamation from Dr. MBRYON Books, &c., received for Review 198 213 228 By BENJAMIN W. . 235 . 249 . 250 THE BRITISH AND FOREIGN MEDICO-CHIRURGICAL REVIEW.. JANUARY, 1877. Analytical and Critical Reviews. I. The Treatment of Phthisis.1 THE claims sometimes put forward on behalf of therapeutics would, if admitted, make the systematic study of pathology well nigh impossible. The due observation of disease undoubtedly depends upon the fact that, strictly speaking, disease itself is for the most part incurable. It is recovered from, but it is rarely stopped by outside interference. If it were otherwise, and appliances had a real efficacy to control or arrest morbid action, the humanity which compelled their employment, would at the same time conceal the phenomena to be observed, as is in a measure the case with ague and smallpox. The study of the natural history of disease would thus be confined to savage communities, or at least dependent on the rare opportunity of inspecting the bodies of those whom some hard fate had suffered to perish by a natural death. The morbid anatomist is little disturbed by such considerations. To him the course of life presents itself as one of progressive and orderly deterioration where, although the manner or the rate may change, the direction is always the same, and steps once taken are never retraced. In what passes for cure he discovers only a rough mending, which can never restore the integrity of the part, while in those secondary vital changes 11. Dr. WILLIAMS (chaps. xxv-vi), Pulmonary Consumption. 2. Dr. HERMANN WEBER, On the Treatment of Phthisis by Prolonged Residence in elevated Regions. Med.-Chir. Trans.,' vol. lii. 3. Dr. THEODORE WILLIAMS, Lettsomian Lectures on the Influence of Climate in the Treatment of Pulmonary Consumption. 4. Dr. J. F. CHURCHILL, Consumption and the Hypophosphites. 117-LIX. 1 |